comparison of efficacy dimenhydrinate and metoclopramide in the treatment of nausea due to vertigo

Conditions: Nausea; Vomiting; Vertigo

Summary: * vertigo complaint is one of the common cause of patients who applied to emergency services. * patients who have applied to emergency services with vertigo complaint mostly have nausea as an additionally symptom to this complaint and anti-emetic agents can be used in their treatments very often. * the investigators purpose is to investigate the advantages of dimenhydrinate and metoclopramide to each other in the treatment of vertigo and the vertigo accompanied by nausea

* vertigo describes the illusion of being subject to an involuntary movement, usually rotational, of the patient or the patient's surroundings which is caused by sudden tonic neural activity. * the management and episodic treatment of patients with spontaneous vertigo related nausea-vomiting symptoms are somewhat controversial in the emergency department setting. * patients admitted to the emergency department with complaints of vertigo in addition to a large portion of the symptoms are accompanied by nausea and antiemetic agents are frequently used in the treatment. * an ideal treatment should be rapid in onset and effective, and lack debilitating side effects. * although a wide variety of classes of pharmacologic agents and modalities are used, the emergency department treatment of acute spontaneous vertigo and associated with nausea- vomiting has not been well studied. * it has been reported that the most commonly used medications for parenteral treatment of vertigo and nausea-vomiting in emergency department are dimenhydrinate (dmt) and metoclopramide (mtp). * it has a depressant action on hyper-stimulated labyrinthine function and antiemetic effects, believed to be due to the antihistamine. * dimenhydrinate inhibits vomiting by affecting the histaminic receptor and cholinergic receptor function center of vestibular nucleus in the central vestibular system. * dimenhydrinate reduces the symptoms of vertigo with depressant effects on the labyrinth function by this means.

Eligibility criteria:
inclusion criteria: * between 18 to 65 years old patients, * had vertigo and accompanied nausea or vomiting \[vas (visual analog scale) score \>5\] during their emergency department episode of care for which the attending physician recommended intravenous antiemetic medication. exclusion criteria: * abnormal vital signs, * women who were pregnant or lactation, * those with a history of epilepsy, * acute psychiatric symptoms, * organic brain disease, * parkinson's disease or phaeochromocytoma, * or any known allergy to the study drugs, * uncooperative individuals, * use of any antiemetic drug in the previous 8 hours or previous delivery of intravenous fluids during the emergency department episode of care, * currently undergoing chemotherapy or radiotherapy, * mechanical obstruction or perforation, * gastrointestinal bleeding, * inability to understand study explanation or outcome measures (any reason), * known allergy or previous adverse reaction to metoclopramide or dimenhydrinate, * and patients who refused to participate study.

Keywords: metoclopramide dimenhydrinate emergency medicine